Tuesday, May 8, 2007

United Amerindian Center curtails services

Despite slashing its hours and staffing, the United Amerindian Center should be able to stay open on a limited basis for at least six months, according to its director.Last week, the board of directors unanimously voted to sever its ties with the Indian Health Services funding stream that provides $2 million to the not-for-profit center each year. However, pulling out of the grant program is temporary and an attempt to start over with the agency with a clean slate. The center plans to reapply for federal funding within 30 days, although there's no guarantee it will receive it.The most immediate effect will be a drop in the center's hours. The center already is open only Mondays, Wednesdays and Fridays, said director Stephen Crowe. Three employees in various capacities were also let go, Crowe said, and all programs offered by the center will suffer because Indian Health Services is the major funding source.The embattled center, which has faced the threat of cuts from the federal government in the past year, offers medical services, transportation and free drug and alcohol counseling to members of any Native American tribe. It is one of two urban Indian health centers in the state that are overseen by Indian Health Services, an agency within the Department of Health and Human Services.In late March, the center received a 90-day extension on its federal funding, which hinged on meeting a number of criteria set forth in what Indian Health Services calls a corrective action plan. At the same time, Crowe — a member of the Menominee Nation — stepped in as interim executive director.However, according to Crowe and board president Anton Williams, additional demands were placed on the center by Indian Health Services even as the center was meeting the original criteria, which included extensive bookkeeping and other administrative changes."We were following every demand by the Indian Health Services, and every time they demanded more," Crowe said. "I believe the (corrective action plan) was set up for failure from the beginning. They kept changing the parameters."According to a statement from Williams, those additional demands included copies of minutes of executive sessions of the board. Crowe said the agency also asked for changes in the center's bylaws and replacements to the board of directors.This is not the first time Indian Health Services and the center have come to a head over the role of the board. Last August, the head of Indian Health Services' Bemidji Area Office in Minnesota brought up concerns about the board's involvement in day-to-day operations.Calls to Indian Health Services were not returned Monday. David Quincy, a health systems specialist with Bemidji Area Office who serves as project coordinator for the center, would not comment on the situation.Despite the cuts, Crowe said the center has enough money to stay afloat for about six months on a limited basis. In the meantime, he is looking for alternative sources of funding."Within 30 days, we are allowed to reapply for the grant," Crowe said. "Our reason is to get rid of the corrective action plan. And I'm making sure we are going to apply for a new project coordinator."About 250 to 300 people use the services weekly, Crowe estimated last month. That number will probably decline with the new restrictions, especially in the transportation services offered to and from various medical appointments.Because the center owns its building at 407 Dousman St. and it's not on reservation land, the building is in no danger of being impounded by the Indian Health Services, Crowe said.

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The above article was published on the front page of the Green Bay Press-Gazette on May 8, 2007. It was the result of a four-page press release sent out by the United Amerindian Center in Green Bay on the previous Friday. I followed up by contacting the Center's new director and speaking with him about the situation.

Basically, the Center has a very good case for showing that IHS representatives acted extremely inappropriately on multiple occasions over the course of several years. When the Center's board and administration chose to confront IHS - with the community's support and participation - IHS official Phyllis Wolfe responded by saying that she chooses not to recognize the authority of the Center's board of directors.

Since when does IHS have the right to trump established state and federal regulation already in place that determines the legitimacy of an agency's board of directors and choose to not recognize a duly elected board solely based on the fact that IHS doesn't agree with their position on certain issues?? What we are dealing with here, folks, is a mega-power trip gone wild.

First, let me clarify something for those of you who may not be familiar with Urban Indian Health Projects aka UIHPs. UIHPs are nonprofit corporations who are tax-exempt under section 501(c)3 of IRS code and are governed by a board of directors that directly reflects the makeup of the local community. They are NOT IHS-owned or IHS-operated facilities. As a matter of fact, almost all UIHPs count upon several sources of funding in addition to any monies they might receive from IHS.

IHS is given an amount of money each fiscal year that is identified for UIHPs. The total amount (just under $33 million) is distributed between each of the 33 UIHPs (this is new as of 2007, there were 34 UIHPs, but IHS chose to sever all funding of the Fresno project earlier this year - forcing it to close its doors).

The idea behind this funding, as dictated by federal policy, is to give UIHPs a resource that they can leverage in obtaining additional funding to serve the healthcare needs of urban Indian people. The IHS funding was never intended to meet the entire need of these communities and the IHS was never intended to operate or regulate these entities. UIHPs are community organizations just like any other nonprofit corporation - they are NOT government clinics.

The Director of IHS, Dr. Charles Grim (see March 27th post), appoints an official to oversee the internal IHS program office for UIHPs. This individual, Phyllis Wolfe, in turn works with Project Coordinators throughout the nation whose job entails ensuring that the UIHPs successfully fulfill their scope of work as outlined in the contracts for IHS urban funding. While common sense dictates that their relationship with the UIHPs should be limited to the monies and scope of work provided for in their individual contracts, in reality - as demonstrated by the Green Bay issue above - the IHS project coordinators and national coordinator often decide to overstep their authority and act as dictators for the UIHPs they are supposed to be partnering with.

IHS officials consistently work outside of their designated role and try to micro-manage facilities that they have neither the experience or the knowledge to run. As community organizations, state and federal law says that these corporations must be run by a board of directors that directly reflect the demographic of the communities they serve. Phyllis Wolfe is not a resident of the Green Bay community, nor can she claim to be an expert in what are the healthcare needs of the local Indian community of Green Bay nor how to best address those needs.

The same can be said of Fresno, Sacramento, Boston and every other urban Indian community. Our communities have the right to support their local UIHP in obtaining staff, board members, funding, services and philosophies that best address the needs of our communities - we are guaranteed that right by both state and federal law!!

I forgot, though. IHS is above the law. Dammit, why did I even bother with this post??...